Manager, Provider Network Operations

We take great strides to ensure our employees have the resources to live well be healthy continue learning develop skills grow professionally and serve our local communities. We invite you to apply for a career with Blue Cross.

Residency in or relocation to Louisiana is preferred for all positions.

POSITION PURPOSE

This leader will be a part of BCBSLAs Provider Data Management transformation by leading Provider Data Management functions and key improvement activities such as process improvement business rules management creating efficiencies and streamlining functions as well as implementing system improvements.

NATURE AND SCOPE

• Manages People
• This role directly manages at least 3 workers
• This role directly manages these jobs : Senior Provider Compliance Analyst Provider Compliance Analyst Special Provider Services Coordinator Senior Provider Information Specialist Provider Information Specialist
• This role reports to this job : Director Provider Network Operations
• Necessary Contacts : In order to effectively fulfill this position the incumbent must be in contact with :

Network Administration Benefits Administration Provider Reimbursement & Audit Medical Management Legal Financial Investigations Marketing IT and Accounting to ensure that proper guidelines are being administered and answer any necessary questions. Regulatory agencies Hospitals Provider Licensing Agencies Physicians Ancillary Providers Billing Entities PHO Administrators and Governmental Agencies that may have questions with their contracting requirements.

QUALIFICATIONS

Education

Work Experience

5 years of experience in a healthcare hospital or related environment require

2 years of leadership required

Skills and Abilities

Licenses and Certifications

ACCOUNTABILITIES AND ESSENTIAL FUNCTIONS

The Physical Demands described here are representative of those that must be met by an employee to successfully perform the Accountabilities and Essential Functions of the job. Reasonable accommodations may be made to enable an individual with disabilities to perform the essential functions

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An Equal Opportunity Employer

All BCBSLA EMPLOYEES please apply through Workday Careers.

PLEASE USE A WEB BROWSER OTHER THAN INTERNET EXPLORER IF YOU ENCOUNTER ISSUES (CHROME FIREFOX SAFARI)

Additional Information

Please be sure to monitor your email frequently for communications you may receive during the recruiting process. Due to the high volume of applications we receive only those most qualified will be contacted. To monitor the status of your application please visit the My Applications section in the Candidate Home section of your Workday account.

If you are an individual with a disability and require a reasonable accommodation to complete an application please contact for assistance.

In support of our mission to improve the health and lives of Louisianians Blue Cross encourages the good health of its employees and visitors. We want to ensure that our employees have a work environment that will optimize personal health and well-being. Due to the acknowledged hazards from exposure to environmental tobacco smoke and in order to promote good health our company properties are smoke and tobacco free.

Blue Cross and Blue Shield of Louisiana performs background and pre-employment drug screening after an offer has been extended and prior to hire for all positions. As part of this process records may be verified and information checked with agencies including but not limited to the Social Security Administration criminal courts federal state and county repositories of criminal records Department of Motor Vehicles and credit bureaus. Pursuant with sec 1033 of the Violent Crime Control and Law Enforcement Act of 1994 individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner.

Additionally Blue Cross and Blue Shield of Louisiana is a Drug Free Workplace. A pre-employment drug screen will be required and any offer is contingent upon satisfactory drug testing results.

Required Experience :

Manager

Key Skills

Field Marketing,Marine Biology,Anesthesia,E-Commerce,Asic

Employment Type : Full-Time

Experience : years

Vacancy : 1